Difficult Conversations in Cancer Care: Lessons from a Student-Led Initiative

With the rising global burden of cancer, healthcare professionals will inevitably be involved directly or indirectly in the care of cancer patients. Although medical education has recently evolved to emphasise the biopsychosocial model, current training regarding difficult communication skills and breaking bad news remains inadequate. Our aim was to utilise a novel method of teaching communication skills through public engagement. This was achieved by setting up a local network of cancer patients who were willing to share their stories to aid student learning. A group of medical students from years one to four interviewed a total of 48 cancer patients about their illness experiences. Student reflections were collated, producing three common themes: (1) knowing what to say, (2) seeing the person in the patient, and (3) understanding the consequences of poor communication. The experiences allowed students to develop their communication skills, learn from patient experiences, and reflect on their future practice. Patient stories, including art, drawings, and poems, were collated in the form of a book and disseminated to promote further learning. We hope our reflections and public engagement initiative will identify key areas of difficult communication, enhance learning, and prepare students for meaningful and often difficult conversation in cancer care. Similar principles could be used in other areas of medical education to allow students to develop safe and effective interpersonal skills.